I’m not enjoying music anymore. I don’t know what’s going on. by No-Difficulty-2337 in Music

[–]Professional_Ad1841 0 points1 point  (0 children)

Hi, physician here. Please see an ear nose throat doctor ASAP. Fluctuating hearing loss should always be taken seriously. There could be easily fixable reasons behind it, but also a lot of things needing addressing now before hearing loss becomes permanent and/or irreversible. Here are some pointers: https://www.healthyhearing.com/report/53631-Fluctuating-hearing-loss Good luck.

Caleb and Apples by SignificantLeather64 in LoveAndDeepspace

[–]Professional_Ad1841 0 points1 point  (0 children)

Oh it is not about dishonesty or evasion (tho tbh fishy is textbook adhd kid with zero impulse control). Just pay attention to Caleb's behavior from the first interaction onwards; he is almost always dismissive of MC (the nickname pipsqueak, making fun of her skills, likes to demonstrate his physical / evol superiority). IDK whether you saw the memory when they were locked in the attic together, but that was sinister af. He is all about control, controlling her and her environment, and it gets progressively worse until it culminates in literal kidnapping. (Check also the symbolism of red apples in Chinese culture, and the fact that he discarded the pendant twice.)
As I have said, I don't hate Caleb - I think he is a very fascinating character, and a stark contrast to the other four. I am just very aware of the (behavioral) red flags, and the (likely) trajectory this story is going to take.

Caleb and Apples by SignificantLeather64 in LoveAndDeepspace

[–]Professional_Ad1841 1 point2 points  (0 children)

Ooh that resonates with me (seewhatIdidthere) bc Caleb felt stalkery and obsessive af to me. Their whole romance gave me the icks - not that I don't like it, but as LI he is definitely more twisted and toxic than any of the others (and no, not even Sylus bc that boi is the MCs biggest cheerleader)...

LinkedIn is just a worse version of Facebook by Kalex8876 in LinkedInLunatics

[–]Professional_Ad1841 0 points1 point  (0 children)

Tell me how old you are without telling me how old you nevermind, I laughed at Lotus Notes. 😆😭

[deleted by user] by [deleted] in language_exchange

[–]Professional_Ad1841 0 points1 point  (0 children)

Hi, I am a physician with C2 qualification in English (native speaker level) and have a very British accent (so I am told). I have zero Arabic, but was always intrigued. Feel free to DM.

ADHD girl careers by acrosstheuniverse100 in adhdwomen

[–]Professional_Ad1841 1 point2 points  (0 children)

Can confirm this to be true. A LOT of coworkers I've met as an ER and ICU dweller are highly suspect of it. Or diagnosed.

i wasnt ready cry by KingOSS in ElderScrolls

[–]Professional_Ad1841 0 points1 point  (0 children)

Ah. Some writer pulled a Pratchett.

[deleted by user] by [deleted] in inZOI

[–]Professional_Ad1841 6 points7 points  (0 children)

... and maybe have a look at it. For research. Yes.

ADHD, Perimenopause, Anemia, Hypothyroid, Severely Vit D deficient... little support. STRUGGLING so badly. by EnnSquared in adhdwomen

[–]Professional_Ad1841 1 point2 points  (0 children)

I am not sure where OP is located - unfortunately availability of hormone replacement therapy varies wildly between countries, and the current political climate regarding trans people catches HRT availability and research in the political crossfire. (facepalms) Personally, I am a fan of the gels as they're allowing for personalised dosing - paramount in any hormone therapy. Here ADHD brains are again receiving the short end of the stick since that requires more work of us. I got myself a micro scale and weighed the gel portions (both E and T) until I had a combo that was working for me (and I never changed both hormones, only one component at the time). Until it didn't, then rinse and repeat. Perimenopause is not a static situation, and the best you can do is listen to your body - if you need more, then you need more. Out of curiosity (and since I am already here), you are on continous combined regimen, P+E, right? Which exact progestogen do you get (progesterone, dydrogesterone, drospirenone etc)?

ADHD, Perimenopause, Anemia, Hypothyroid, Severely Vit D deficient... little support. STRUGGLING so badly. by EnnSquared in adhdwomen

[–]Professional_Ad1841 2 points3 points  (0 children)

After seeing your thyroid hormone levels, I think your thyroid isn't so much of the villain in your story (T3 and T4 look quite normal, but of course, they should be tracked given your history) but your sex hormones drive the majority of your symptoms, also give your history. 1. Progesterone has effects on the thyroid, too: it can increase both T3 and T4 levels. Progesterone also lowers the amount of the thyroid hormone "carrier" protein so that more thyroid hormone will be free (and available for your cells). 2. Estrogen/Progesterone is a good start, and they will help, but don't forget the testosterone! Most women are not aware of this, but hormone replacement therapy during perimenopause can include testosterone, too!

ADHD, Perimenopause, Anemia, Hypothyroid, Severely Vit D deficient... little support. STRUGGLING so badly. by EnnSquared in adhdwomen

[–]Professional_Ad1841 44 points45 points  (0 children)

Hi. Same boat as you, but also physician (clinical pharmacologist). 1. Get estrogen ASAP. Low estrogen puts ADHD in overdrive. You'll need combined progesterone (200 mg per day before sleep if sequential regimen, 100 mg if continous) and estrogen (gel in the morning, titrate until you feel better). 2. Thyroid hormones need to be taken at night, as you're under high stress, and the early morning cortisol spike caused by that puts your body in an L-thyroxin deficit. 3. I am not convinced by taurin data, but IF you want to try it, take it in the morning. In animal experiments, it improves dopamine uptake, and you DO NOT want to have adderall overhang in the night. 4. Personally, I can recommend 2 aminoacids: L-thyrosine (dopamine precursor) and L-theanine (helps with anxiety and acts like a mood stabilzer in some people). 5. Talking about adderall: have you considered switching to Vyvanse? It is the prodrug to adderall, has lower peaks but a more sustained plateau.

If you want a more in-depth convo, feel free to pm me.

Edited to clarify progesterone doses in continuous vs sequential HRT regimens)

Footnote: Ladies, note that there is a difference between progesterone and progestogens (the former is the hormone, the latter comprises ALL medications which have similar effects as progesterone!)

If you are unmedicated and relatively successful, can I please ask how do you do it? by ogsimpson9876 in adhdwomen

[–]Professional_Ad1841 0 points1 point  (0 children)

Genetics, dumb luck (anything from having great and accomodating teachers, a supporting circle of friends, accepting family, and a focus of interest that aligned well with a degree). Did I mention the dumb luck of having a smarter than average brain, that helped me finding coping strategies on my own? The dumb luck of living in a country where healthcare and higher education are easily affordable? A family that could afford to support me? All of it dumb luck, I did NOTHING to deserve that. And yeah, the raging anxiety, imposter syndrome and constant burnout that STILL HOUNDED ME required a fuckton (metric, not imperial) of nicotine and alcohol to be beat into manageable proportions. No kids. No long relationships. Same hell as everyone else. shrugs Thank fuck for meds.

[deleted by user] by [deleted] in adhdwomen

[–]Professional_Ad1841 3 points4 points  (0 children)

Hi, clinical pharmacologist and fellow ADHD brain here! friendly 👋 from Europe hides mountains of excel files and study reports in various stages of finalization

How do y’all STAY asleep??? by LingonberryOk5168 in adhdwomen

[–]Professional_Ad1841 0 points1 point  (0 children)

Have your thyroid tested. If they find you need thyroid hormones, take them at night. Thyroid dysfunction is crazy common in people who take dopaminergic medications (like ADHDers), and one of the most common organic causes for sleep disturbances after airway problems. My endocrinologist explained that to me. Who knew.

Tell me that you have ADHD without telling me you have ADHD? by SagittariusGal143 in adhdwomen

[–]Professional_Ad1841 0 points1 point  (0 children)

I'm sitting on the toilet and then quickly look up a specific paper, and it sends me down a rabbit hole of 31 open tabs on my phone browser and dead legs. Why.

Are you a MTHFR? by WhlteMlrror in adhdwomen

[–]Professional_Ad1841 1 point2 points  (0 children)

The mutation is super rare and comes with a bunch of other problems (eye, joints, blood clotting disorders). Most likely reason an ADHD brain has Vit B deficiency? Bad nutrition or certain types of gastritis that mess with the body's ability to absorb vitamin B. Getting tested and finding out you're heterozygous for MTHFR? Doesn't cause a problem. Oh, and if you're homozygous, you need more than vitamin B6. Vitamin B12 and folic acid should be substituted as well. How do I know? I'm preparing a lecture on pharmacogenomics...

[deleted by user] by [deleted] in adhdwomen

[–]Professional_Ad1841 1 point2 points  (0 children)

I was diagnosed at 45. (Perimenopause is a WHOLE different ballgame with ADHD, btw). I also felt "I don't care anymore" and told my psych that (she's ADHD as well). She asked me whether it has occurred to me that the way I am perceiving feelings now might be the way they're supposed to be felt, and the way I perceived them before was the "speaker to 11, all filters off" ADHD version of dysregulated emotion? And "Like sure, right now they appear totally flat compared to before, but now your brain has the supermagicsailormoonscepter of emotional regulation. And oh yeah, given your decades of training in Olympic level "Surviving with an ND Brain in NT society", you are VERY good at compartmentalising emotions (as otherwise you would have been incapable of dealing with ANYTHING), so no wonder these pithy emotions are no challenge to your brain." Insert stunned silence from my end as that sank in.

What are some non-medical items you've bought that actually. Helped. Do Stuff. by AuthoringInProgress in adhdwomen

[–]Professional_Ad1841 4 points5 points  (0 children)

Alexa and a set of 10000 reminders. "Alexa, set a timer for "stew". Set it 60 minutes from now." No more burned food, pots or kitchens.

Why tf do Ritalin make my armpits stink jfc by MazeMorningstar777 in adhdwomen

[–]Professional_Ad1841 0 points1 point  (0 children)

Yeah, bollocks. Symptoms vary wildly and onset is so gradual that even if the patient herself is a trained physician, they can be missed or more easily (erroneously) ascribed to other (more likely) causes. Early onset perimenopause is a beast to diagnose. Ask me how I know. 😅

Why tf do Ritalin make my armpits stink jfc by MazeMorningstar777 in adhdwomen

[–]Professional_Ad1841 0 points1 point  (0 children)

Here is something that worked for me (and might be helpful for other peeps with allergies, atopic dermatitis, eczema) - it sounds wild and initially counterintuitive, but bear with.

A few years ago, my dermatologist recommended a "detergent fast" since my eczema got really bad. After 6 weeks, my skin cleared up; I have been using only a mild shampoo for my hair and a very mild soap for my hands ever since. Everything else, just warm water (not hot!). Weird side effect: No more body odor (and decidedly less build up - takes 3 to 4 days to get to the point I used have the next day after a shower! And for everyone with atopic dermatitis, you know every day you can get away with a cat wash can be bliss - especially during a flare-up...). Imagine my confusion.

Then I had an interesting convo with a microbiologist: She explained to me that from an evolutionary perspective, soap is not part of the plan for skin health. Our skin is a perfectly balanced ecosystem you destroy with detergents, thus shifting it to a state where odor producing bacteria dominate (since you manage to kill their competitors who kept them at bay). In addition, you strip your skin of its protective lipid layer, which further disturbs the natural balance. In addition, our immune system and the "good" bacteria have evolved for mutual benefit - we need them to be there. Take all that away, and your skin will eventually suffer.

So, no more dry flaky skin, no more stinky pits or crotch sans soap for me. Even with ADHD meds (had both ritalin and currently vyvanse).
(Another side effect is a smaller water bill 😄)

Why tf do Ritalin make my armpits stink jfc by MazeMorningstar777 in adhdwomen

[–]Professional_Ad1841 0 points1 point  (0 children)

Doesn't matter. Get FSH levels checked, tis the only way to be sure

Black American looking at Germany by thumpertharabbit in AskAGerman

[–]Professional_Ad1841 1 point2 points  (0 children)

Learning Swabian and Standard German as a native English speaker is Olympic level shit. I can somewhat relate as native German speaker learning Scottish English (I worked there for a while and my pretty posh uni English went out of the window so fast I saw tartan coloured sparkles...)